Survey Provides a Window Into Payers’ Decision-Making Process

June 2010, Vol 1, No 2 - AMCP Annual Meeting


San Diego—Payers believe that prescribing information, national guidelines, and prospective controlled randomized trials (PCRTs) are the most useful sources of information about oncology drugs, according to researchers from Genentech, Inc (South San Francisco). Presenting their findings at the Academy of Managed Care Pharmacy’s annual conference, lead researcher Ellen Yang, PharmD, noted that the study’s conclusions may help manufacturers more easily meet the evidentiary needs of payers while remaining within regulatory and legal boundaries.

The study consisted of a 22-item electronic survey that questioned payers on their oncology drug review process and the types of evidence they use when making formulary, coverage, and reimbursement decisions. The overall response rate was 15%. Of those who responded, 79% managed oral cancer drugs, and 52% managed intravenous therapies; 83% were pharmacists.

Survey results showed that 83% said prescribing information was “useful” or “very useful,” followed by national treatment guidelines (80%), and PCRTs (76%). Economic models fell at the bottom of the list (13%), along with noncontrolled trials/retrospective studies (13%), and published pharmacoeconomic studies (17%). Approx imately three-fourths of survey respondents noted that they value AMCP dossiers and reprints of study articles from peer-reviewed journals.

Although the sample size was small, Dr Yang believes the findings still provide valuable information for manufacturers looking to optimize their communication with payers. According to Peter Neumann, ScD, director of the Center for the Evaluation of Value and Risk in Health at Tufts New England Medical Center, the survey “underscores that payers are looking at multiple sources for evidence on the clinical effectiveness of oncology drugs and that they value rigorous design and independently conducted or verified analyses.”